Résumé
Visceral leishmaniasis is a common tropical disease. This study was carried out on 85 patients during the period between October 1994 and December 1995 in Al-Salam Hospital at Sana'a, Republic of Yemen. Visceral leishmaniasis was diagnosed in 82 cases on history, physical findings and laboratory tests with positive leishmania donovani bodies on microscopy of splenic aspirations and was suspected in three cases on clinical, hematological and biochemical grounds only. The commonest presenting clinical findings were fever [100%], splenomegaly [100%], anemia [100%], hepatomegaly [67.1%], abdominal distension [70.7%], anorexia [63.4%], respiratory [16%] and gastrointestinal symptoms [21.9%]. The consistent laboratory findings were anemia [mean Hb level 6.3 g/dl], neutropenia [mean level 2.1 g/dl] and low serum iron [mean level 26.4 mug/ml]. Bone marrow aspiration was positive for leishmania donovani bodies in 48.8% of cases, liver biopsy was positive in 47.3%, while splenic aspiration was positive in all cases [100%]. Both groups of patients [the confirmed 82 patients and the suspected 3 patients] were given sodium stibogluconate 20 mg/kg body weight IM for 30 days. After this regimen of treatment, all patients were reevaluated where the first group showed good clinical and laboratory response with negative splenic aspiration for leishmania donovani bodies, while the second group showed no response and further investigation proved illnesses [two cases were Schistosoma mansoni and one was tuberculosis]